Impact of routine oral care on opportunistic pathogens in the institutionalized elderly.

Routine oral hygiene is important for the control of opportunistic pathogens in the oral cavity of institutionalized elderly individuals. We evaluated the effects of routine oral care on opportunistic pathogens at various time points after admission to a nursing home. Twenty-five elderly subjects living in the nursing home (mean age: 86.0 +/- 10.4 years) participated in the study. Caregivers and dental hygienists cleaned the teeth, dentures, tongue, and mucosa after each meal using both routine and professional oral care techniques. Opportunistic pathogens were collected from the teeth, tongue, and mucosal surfaces using a cotton swab; and the species of microbes were determined and the numbers were counted following cultivation on selective agar. Regular oral care including professional oral care was found to be effective for reducing infections by many kinds of opportunistic pathogens on the teeth surfaces and the oral environment without food residue during a long-term study (6 months). Further, this care after 1 month significantly reduced infections by opportunistic pathogens on mucosal surfaces in subjects without dentures; however, this was not observed in those with dentures. Our data shows the importance of regular oral care in cleaning hard and soft surfaces of the oral cavity improves the oral health of the institutionalized elderly.

Relationship of cariogenic bacteria levels with periodontal status and root surface caries in elderly Japanese.

OBJECTIVE: The relationship of the levels of cariogenic bacterial species with periodontal status and decayed root surfaces was investigated in elderly Japanese subjects. METHODS: Three hundred and sixty-eight individuals (each 75 years old) were examined for periodontal status (pocket depth, attachment loss), root surface caries and salivary levels of mutans streptococci (MS) and lactobacilli (LB). RESULTS: Values >4 mm of attachment loss (rAL4) and for average attachment loss (aAL) of sites measured were significantly higher in subjects with LB than those without. Multiple regression analysis also showed a correlation between aAL and rAL4 values with the presence of LB (aAL p = 0.003; rAL4 p = 0.002). Further, multiple regression analysis of interacting factors regarding decayed root surfaces showed that LB carriers had a greater incidence of decayed root surface caries (p = 0.003), while MS and LB levels were correlated to the number of decayed root surfaces (LB p = 0.010; MS p = 0.026). CONCLUSION: Our results indicate that considerable attachment loss elevates the possibility of having LB, thus increasing the risk of root surface caries. It was also found that LB and MS measurements may be useful indicators of decayed root surfaces in elderly individuals with attachment loss.